Mesoplasty with Pedanculated Seromuscular Flap in Type IIIb Jejuno-ileal Atresia

Jejuno-ileal atresia occurs as a result of an intra-uterine ischemic insult to the midgut. Type III b (apple peel) or (Christmas tree) deformity consists of proximal jejunal atresia, absence of the superior mesenteric artery, agenesis of the dorsal mesentery, a significant loss of intestinal length and a large mesenteric defect [1]. After the surgery, whether short bowel syndrome is occurred or not, it is important to begin enteral feeding as soon as possible. Short or absent true mesentery, coiling of distal small bowel around single vessel, and prevention of postoperative recoiling or volvulus are important challenges associated with type III b atresia besides short bowel syndrome.